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Trends in online emergency responder education

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Presentation by Greg Friese, MS, NREMT-P for EMS World Expo 2011 in Las Vegas, Nevada. Online education continues to be the most dynamic and fastest growing component of emergency responder education. ...

Presentation by Greg Friese, MS, NREMT-P for EMS World Expo 2011 in Las Vegas, Nevada. Online education continues to be the most dynamic and fastest growing component of emergency responder education. This session will discuss the latest trends in online emergency responder education. We will also discuss emerging trends in online emergency responder education and discuss how to evaluate tools and technologies for your organization.

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  • Welcome. EMS World Expo presentation: Trends in Online Emergency Responder Education.
  • Welcome to the sessionFill out the evaluationEnjoy your time at EMS World Expo
  • This is my task … from my application as a presenter. And the conference program.
  • The Objectives I submitted to present.
  • What your tasks are for this session. Listen … if you wantImagine … possibilities for online educationExplore by asking questions … now and later … seek to understand how these trends will or will not impact your organization?
  • My primary role is director of education for CLSHave been involved and engaged in online education development, production, and use since 2004.Variety of online education involvement:Continuing education coursesPodcasts hostBlog authorWeb videos Microblogging
  • Online education means a lot of things to a lot of different people. Mix of definitions – distributed, distance, web-based, internet, online education. Tough to put it into a tidy box.
  • Conjures up a lot more opinions and emotions than other types of education. Probably because we don’t have a shared sense of what is or what is quality online education. Some of you might be here because you don’t believe online education has a role in EMS education.But can you imagine having a conversation about whether we should or shouldn’t use lecture or preceptors. Those are accepted, regardless of quality or actual measurable outcomes. Comparison of our ability to judge quality – audio vs visualsAudio – we all consume lots of audio media, radio, television, even announcements at the airport. We have a finely tuned sense of what good audio sounds like. Visuals – we don’t have a fined tuned sense of what a good PowerPoint slide is. The audience, probably because of lots of negative experiences is very forgiving of bad PowerPoint slides.
  • I envision a future where consensus will develop about the definitions of what online education is and it will conjure up a fairly expected set of opinions and beliefs.
  • [graphic need … something new … Lucas, Autopulse, capnography, hypothermia, EZ-IO … maybe a product from the show floor … how do you go from the show floor to actual use in the ambulance]
  • [What is] Slow adoption of new equipment and techniques for patient assessment, treatment, and transport ... As shown in this product implementation cycleAdoption time measured in months or yearsLong cycle to put a new innovation – product, technique into serviceOften performed in linear stepsMany steps could be done in parallel – such as purchase, update protocol, and deliver training AwarenessDecision to purchaseBudget to purchaseIdentify and compare alternativesSelect preferred productPurchase productReceive product and intake into inventoryUpdate protocol Prepare training Deliver training Start using productEvaluate effectiveness of productRe-order or replace product
  • [What should be]Rapid innovation should be measured in hours, days or weeksHow do you compress the product implementation cycle? Work in parallelUse online education content
  • All product launches have an associated YouTube video, blog posts, content that is enduring and available anywhere
  • All product launches have an associated YouTube video, blog posts, content that is enduring and available anywhere
  • Delivery of training needs to be independent of time, place, and availability of instructor AND audience
  • Create training groups and assign tasks inside a learning managementsystem. Track completion that allows real-time reporting of completion … not just a stack of sign-in sheets.
  • Marathon running training plans. Driven by three pillars – data, individual goals, and coach prescription16-20 weeks to run and work-out four to six days a weekDriven by:Current level fitnessTime available for trainingDesired effort of exertionFinishing goal Training plan adapts to experience, environmental conditions, injury/illness, schedule, and actual results. Adapted to the Individual
  • NREMT recertification hours. Current paramedic learning plan in the US:
  • Homogenous mandatory training plan for all providers. One size fits all. Rehash of previous training programs.Broad, but shallow … no depth.
  • So broad we are overwhelmed with choices. “I need more airway courses?”“What should those courses be on?”“Airway”“What kind of airway courses?”“They need to be about airway”“Exactly, a course about airway. I need to know more about what you need.”Replace the word airway with salad dressing, jam, toilet paper.No relation to DATA from field experience, community served, clinical competency,
  • Replace the word airway with salad dressing, jam, toilet paper.
  • Needs to be related to and guided by DATA from field experience, community served, clinical competency,
  • Data driven competency evaluation and provider self-assessment to create unique training plans3 pillarsDataSelf-directedTraining officer assigned
  • Plentiful data sourcesCan use these sources independently or in combination
  • Field surveillance (slope for influenza cases changes)[Google Flu trends]2007-2008 – flu cases spike in February. When should you schedule training for following years? 2009-2010 –flu cases spike in September
  • Question to the audience: What events could monitor for with existing data sources.
  • What does this waveform tell you about the endotracheal tube? After intubation if capnography is not used to confirm tube placement … as documented in the PCR and from monitor data … what happens next.
  • Protocol Adherence - EtCO2 monitoring is the standard for any intubated patient, but we know it is often not used. Rapid analysis of the PCR data could immediately check for intubation performed and EtCO2 monitoring. If capnography was not performed a series of automated actions might include a template email from the medical director with a link to a form asking the paramedic to explain why EtCO2 was not used and how airway placement was confirmed. The same email could also include a link to a PDF of the airway management protocol, an instructional video of adding EtCO2 monitoring to the airway circuit, and an assignment to complete an online CE module on interpreting capnography waveforms.
  • [EMT with pediatric patient, another example Women in active labor]Pediatric patient encountersLow Frequency Encounters – depending on your service area there is likely a known sub-set of low frequency encounters. In a heavily geriatric community a paramedic could go months without encountering a pediatric patient. A simple automated analysis of CAD data could determine which paramedics have not had pediatric patient encounters and then assign appropriate continuing education modules, case reviews, and observation opportunities. Similarly, if a paramedic has gone a certain time period, such as 24 months, without encountering a patient in active labor the paramedic could be scheduled for a practice delivery in the simulation lab or live birth observation/assistance at the local hospital.
  • Blood pressure assessments [scroll of systolic and diastolic pressures, 95% are between 115 and 125 mm Hg]
  • [Screen shots … blogs, websites, podcasts]Self-Assessment that leads to niche expertise. Examples:TomBouthillet – 12 leadKyle Bates – EMS instruction, pedi-u, first few moments. Dan Limmer – test prepStephen Rahm – test questions[interesting connection between entrepreneurship, self-promotion, and self directed learning to obtain niche expertise. Also share a huge amount for free]
  • Choice! Steps towards attaining niche expertise. Gain depth. Annual or bi-annual learning plan:SeminarsClassesBooksArticlesDiverse assignmentsOnline courseClassroom courseOne to one meetingSelf directed learningSimulationGroup discussionCase reviewTesting Not just consumption but also application of knowledge
  • Self Assessment should answer these questions:What are you really good at?How do you know you are really good at those things? DATA!What do you want to get better at?What do you need from the organization to get better at those things?
  • Individual learning plan is validated by and accountable to a training officerSome connection to social networks and key opinion leaders to influence and validate those learning plansInfluenced and validated by Social CirclesTraining officerCoworkersSocial networksKey opinion leaders
  • [graphic … field provider and paths to these different careers with EMS]Prepares for different advancement paths … LeadershipFinanceBillingMarketingCustomer serviceEducationFTO/Preceptor Human resourcesIT infrastructure
  • Link to associates and undergraduate degree completionPathway towards advance degree attainment
  • There will always be a need for training assigned by a training officer to fulfill regulatory requirements. Top priorities of training officers:Completion of a certain amount of timeMeets requirementsEveryone is presented the same information Maybe some throwaway words like “good” “useful” or “interesting” or “informative”
  • Training officer assigned content as it exists now. A need is identified. It is deliveredTraining completed.Where in this process does competent fit?Does it even matter to the training officer that just wants to know
  • If you are going to assign training at least give people the opportunity to “test out” by completing a knowledge or competency assessment. Credit (or at least a free pass) for stuff you already knowCreate pathways depending on results of competency assessment.
  • EqualNowWhat could be? Different for different people or different years?[animate how total training could expand or contract based on percentages in each pillar]
  • Online education is as effective if not more effective than classroom education. Online education is most effective when it is part of a hybrid education program – classroom and online
  • Today most “hybrid education” is silo or pre-requisite driven. Especially in the continuing education world. Do A and then do B. Take the lectures and then come to the lab.
  • Classroom and online happen in parallel to meet different learning, instructional and behavioral objectives. Variety of activitiesOnline contentOnline activitiesClassroom contentClassroom activitiesSimulationSelf-directed learning
  • Training is still a place and a time. “the EMS academy” or “the training room” is a physical location with set hours, equipment, staff, and use potential.
  • The EMS professional goes to training at a fixed time and location. Indianapolis Fire Department example:Minimum of 120 station visits, but likely 150-160 station visits to get 100% compliance First 75% is easyNext 25% is very difficult4 full time staff to accomplishRegardless of who goes where, the model is based on a physical location being “open” for training at a set-time.
  • Training goes anywhere the provider goes … or anywhere the provider can access the internet … which is anywhere the provider goes.
  • Training technologies and tools. Just need an internet connection.
  • These are the obvious delivery technologies for EMS professionals. Work provided or personal.
  • Other devices that certainly have the microprocessor capacity to deliver training. AED – one of the few medical devices providing just-in-time training … push hard, push fast, push to shockOther devices … Immediately available training on rarely used treatmentsDrug dose calculationsChecklists for using the IV pumpLaryngoscope – cord recognition
  • Making training content available anytime, anywhere can be done with a learning management system.It can also be done with file sharing/storage tools like Dropbox. Web-base software … removes responsibility of hosting software, minimizes outages, relieves data storage pressureGoogle documents, YouTube for video, Slideshare, Scribd.com …
  • Group video chat, can bring training anywhere and anytime. Exploded July 2011Skype Google+Facebook integration of video chatFREE (or low cost) and Easy!Also a standard feature in web based meeting products like GoToMeeting and WebEx[Skype group chat screen shot, Google+ hangout, Facebook video chat … ]
  • 12 leads commonly mailed to medical director … The last person that needs to see more 12 leads12 lead could be distributed (email or other web services) to … Paramedic that capturedAll paramedics (group distribution list)Facebook page (closed)Flickr accountBlog and then comments used for group discussionLearning Management SystemOther? In learning management system used to create:Competency testGroup discussion
  • 12 leads commonly mailed to medical director … The last person that needs to see more 12 leads12 lead could be distributed (email or other web services) to … Paramedic that capturedAll paramedics (group distribution list)Facebook page (closed)Flickr accountBlog and then comments used for group discussionLearning Management SystemOther? In learning management system used to create:Competency testGroup discussion
  • Education content created and delivered by experts in a limited number of channelsAt one time the hardware device shaped how the media could be delivered. Example VHS and BETA. Hardware only plays media from one type of storage device. Because of the limitations of the hardware there was a premium of getting it just right because you only had one chance to publish and print the book or tape or DVD.
  • Now media drives the process since virtually all hardware tools can deliver the media. The cost of media production has dropped significantlyNiche experts leverage free or low cost and easy to use hardware and software tools to create and distribute content
  • Let’s build a Training Mash-up using online content. What could we put into it?EMS World magazine article about CPAPPresentation from Slideshare about pathophysiology of heart failureLink to department protocolsAudio file of a case a CPAP case review conducted on Skype (recorded with CallBurner)YouTube video of assembling and applying a CPAP device (field personnel generated or from the manufacturer)Quiz/Survey tool to ask different types of questions, High fidelity patient simulator
  • Let’s build a mash-up on capnography … where are you going to look.

Trends in online emergency responder education Trends in online emergency responder education Presentation Transcript

  • Trends in Online Emergency Responder Education
  • Introduction
    Welcome
    Evaluation
    Enjoy
  • My Task
    Online education continues to be the most dynamic and fastest growing component of emergency responder education. This session will discuss the latest trends in online emergency responder education. We will also discuss emerging trends in online emergency responder education and discuss how to evaluate tools and technologies for your organization.
  • My Task
    Describe the latest trends in online education
    Discuss emerging technologies that will impact online education
    Answer attendee questions about online education trends
  • Your Tasks
    Listen
    Imagine
    Explore
  • Greg Friese, MS, NREMT-P
  • Online Education
    Define?
  • Online Education … what it is
    Opinions
    Emotions
  • Online Education …what it should be
  • Assessment and Treatment Innovations
    Maroon & White Specialty Services
  • Implementation Cycle
    Product
    How Long Does This Take?
    Purchase
    Training
    Use
  • Innovation Diffusion
    Product
    Purchase
    Training
    Use
  • Electronic Training Content
  • Electronic Training Content
  • Anytime, Anywhere Delivery
  • Groups and Tasks
    X
    X
    X
    X
    X
    X
    X
    X
    X
    X
    X
    X
  • Marathon Training
    Data
    Time Goal
    Coach
  • Paramedic Learning Plan
  • Refresher and Continuing Education
  • Actual Conversation
    “I need more airway courses.”
    “What kind of airway courses?”
    “Airway”
    “Airway courses of what type?”
    “It needs to be an airway course”
    “Exactly, a course about airway. I need to know more about what you need.”
  • Similar Conversation
    “I need more salad dressing.”
    “What kind of salad dressing?”
    “Salad dressing”
    “Salad dressing of what type?”
    “It needs to be a salad dressing”
    “Exactly, a salad dressing. I need to know more about what you need.”
  • Refresher and Continuing Education
    Experience
    Competency Goal
    Training Officer
  • Individual Learning Plan
    ASSINGED
    SELF
    DATA
  • Pillar I: Data
    CAD
    ePCR
    Bio-Surveillance
  • Bio-Surveillance
    Best time for training?
  • Train When Slope Changes
    Training No Longer Needed
    Training Needed
    Now
  • Bio-Surveillance
    What events could you monitor for with existing data sources?
  • Protocol Adherence
    50
    40
    30
    20
    10
    0
  • Protocol Adherence
    Failure to use EtCO2triggers:
    Email from medical director
    Google Doc form to explain not using
    Link to PDF protocol
    Assignment of online lecture
    Assignment to simulator lab
  • Pediatric Encounters
  • Blood Pressure
  • Pillar II: Self-Directed
    Paramedic Knowledge
    Paramedic Knowledge
    Broad and Shallow
    Paramedic Knowledge
    Niche Expert Goes Deep
    12-Lead ECG
    Pediatrics
    Test Success
    Assessment
  • You Decide!
    Seminars
    Classes
    Books
    Articles
    Diverse Assignments
    Testing
    Online Courses
    Classroom Courses
    Expert Interviews
    Simulation
    Discussions
    Case Review
  • Self Assessment to Create Learning Plan
    What are you really good at?
    How do you know you are really good at those things?
    What do you want to get better at?
    What do you need from the organization to get better at those things?
  • Validated and Accountable
    Me
    Training Officer
    Co-Workers
    Social Networks
  • EMS Career Paths
    Leadership
    Finance
    Billing
    Marketing
    Customer Service
    Education
    FTO/ Preceptor
    Human Resources
    Information
    Technology
    Paramedic
  • Pathway to Degree Completion
    Paramedic
    Bachelors Degree
    Masters Degree
    ?
  • Pillar III: Assigned
    Restricting navigation
    Must sit for a certain time before test
  • Training Officer Assigned
    Training Need
    Deliver to All
    Competent?
    Completed
  • Training Officer Assigned
    Training Need
    Competent?
    No
    Training
    Yes
    Complete
  • Distribution of Hours
    100%
    Training Officer
    Training Officer
    Training Officer
    Training Officer
    Training Officer
    Self
    Self
    Self
    Self
    Data
    50%
    Data
    Data
    Self
    Data
    Data
    0
  • Hybrid Education
    Online education is most effective when it is part of a hybrid education program
  • Hybrid EducationSequential
    Certification
    Online
    Classroom
  • Hybrid EducationParallel
    Certification
    Online
    Classroom
  • Training is a Place and Time
    Training
    Academy
    Dedicated:
    Location
    Hours
    Equipment
    Staff
  • Training is a Place and Time
    Station 2
    Station 1
    Station 2
    Station 1
    Station 2
    Station 1
    Training
    Academy
    Station 3
    Station 4
    Station 3
    Station 4
    Station 3
    Station 4
  • Station Based Training
    # of Stations
    X
    # of Shifts
    X
    Visits per Station
    =
    100% Compliance
  • Location Independent
    Training goes to the provider
    Mobile Hotspot
    3G connection
    WiFi for onboard devices
  • Training Technologies and Tools
  • Delivery Technology
    Notebooks/netbooks
    Tablets
    Smartphones
    Desktop computers
    Web enabled TV/DVD player
  • Delivery Technology
    AED
    Cardiac monitor
    IV pump
    Ventilator
    Video laryngoscope
  • Web Based Content Storage
    Learning management system
    Cloud storage
    Browser based apps
    Social Networks
  • Group Video Chat
    Skype
    Google+
    Facebook
  • Evaluating Tools and Technologies
    Rapid implementation
    Web based
    Multiple delivery platforms
    Competency and data driven
    Automate sharing and assignment of content
    Support training mash-ups
  • Automated Sharing
    H
  • Automated Sharing
    Social Network
    Photo Sharing Site
    Blog
    LMS
    Email Group
  • Hardware Device DrivenTraining Content
  • All hardware can deliver all training media
    Media DrivenTraining Content
  • Making a Mash-up
    Select topic
    Search for content
    Embed and link to content from single place
    Add your own content
    Social conversation
    Assessment
  • CPAP Training Mash-Up
    Magazine article
    Slideshare presentation
    Link to protocols
    Audio file of case review
    YouTube video
    Quiz/Survey tool
    High fidelity patient simulator
  • Capnography Mash-Up
  • Mash-Up Content Sources
  • IO Mash-Up
    KyleDavidBates.com
  • Summary
    Rapid diffusion
    Data driven
    Self-directed
    Time independent
    Location independent
    Curator
  • Questions
    Search
  • Let’s Stay in Touch